Predictors for developing strabismus after paediatric cataract surgery
Reviewed by Fiona Rowe

This study investigates the predictors for strabismus development in patients with paediatric cataract and their final visual acuity. The aim was to improve the treatment of both deprivation and strabismic amblyopia after surgery. The study included 46 children; 21 male, 18 unilateral and 28 bilateral cataract. Surgical treatment was given for 74 eyes. Systemic conditions were noted in five patients including Lowe syndrome, muscular dystrophy, optic nerve dysplasia, galactosemia and Down syndrome. Strabismus was present in 33 cases (77%); 15 (83%) with unilateral and 18 (64%) with bilateral cataract. Strabismus frequency was higher in those operated at 0–6 months of life (84%) and in aphakic patients (90%). Esotropia was present in 35%, exotropia in 33% and hypertropia in 4%. For unilateral cataract cases median esotropia angle was 30PD and 20PD for exotropia. For bilateral cataract cases median esotropia angle was 20PD and 25PD for exotropia. Predictors associated with diagnosis of strabismus included age at surgery, intraocular lens implantation and distance best corrected visual acuity in the worst eye – in univariate analysis. With multivariate analysis, only age at surgery remained as a significant association. The authors observed the protective benefit of not developing strabismus associated with intraocular lens implantation vs. aphakic children. They recommend careful follow-up and observation for strabismus.

Strabismus development after pediatric cataract surgery associated with age at surgery, intraocular lens implantation and visual acuity outcome.
Filho CM, Messias A, Antunes-Foschino R.
STRABISMUS
2023;31(2):139–44.